What is a psychodermatological disorder?

A psychodermatological disorder is a condition that affects both the skin and the mind. It has both physical andpsychosocial components. In these cases, effective management of the skin disorder must take into account the psychological/psychiatric factors.

Researchers use the term ‘neuro-immuno-cutaneous system’ (NICS) to describe this relationship.

Classification of psychodermatological disorders

Psychodermatological disorders may be divided into three categories:

Psychophysiological disorders, where emotional stress can exacerbate symptoms; an example is psoriasis

Primary psychological disorders, where the psychological condition results directly in cutaneous symptoms, such as delusions of parasitosis

Secondary psychological disorders, where a disfiguring skin condition can lead to psychological problems such as depression.

Assessment tools for psychodermatological disorders include the following questionnaires:

The Dermatology Life Quality Index (DLQI) or Children’s Dermatology Life Quality Index (CDLQI)

The Person-Centered Dermatology Self-Care Index (PeDeSI)

The Psoriasis Disability Index (PDI)

The Dermatitis Family Impact (DFI) questionnaire.

Pharmacological options for psychodermatological disorders

The pharmacological treatment options for the psychological/psychiatric factors involved in psychodermatological disorders depend on the type of disorder being treated. They can include:

Antidepressants, which are used if depression is exacerbating a dermatological condition (note: tricyclic antidepressants also have antihistaminic properties).

Obsessive–compulsive disorder is associated with trichotillomania (compulsive hair-pulling), onychophagia (nail biting), hand dermatitis from frequent hand-washing, and other skin conditions; SSRIs, such as fluoxetine, paroxetine, sertraline and fluvoxamine, have been proven to be effective for its treatment in clinical trials.

Non-pharmacological options for psychodermatological disorders

Non-pharmacological treatments available for the psychological/psychiatric factors involved in psychodermatological disorders include: